Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $192.72 / $192.72 / $192.72	Facility		$192.72	$192.72	$192.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.72 / $263.08 / $1,199.54	Professional		$192.72	$263.08	$1,199.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.83 / $302.83 / $302.83	Facility		$302.83	$302.83	$302.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.41 / $302.83 / $302.83	Professional		$257.41	$302.83	$302.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $222.69 / $222.69 / $222.69	Professional		$222.69	$222.69	$222.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.76 / $109.76 / $302.83	Facility		$109.76	$109.76	$302.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $257.41 / $302.83 / $409.40	Professional		$257.41	$302.83	$409.40
United Facility/Professional Facility Modifier Low / Median / High Price $130.99 / $224.66 / $243.30	Facility		$130.99	$224.66	$243.30
United Facility/Professional Professional Modifier Low / Median / High Price $157.19 / $170.01 / $260.16	Professional		$157.19	$170.01	$260.16